Police Procedure - the Autopsy

by Tracey Hawkins

 

Do you recall a time when you've been in danger, or feared that you could be in danger? Remember that adrenalin surge through your body, how alert your senses were? This wonderful primitive response to ensure our survival is called the "Fight-or-flight response."

I was only twenty-two years of age when I first unlocked a mortuary fridge door and felt that response kick in.

Let me set the scene for you.

 

It's about three am on a cold Canberra winter night. The rain is teeming down outside. I am balanced precariously on a small stool trying to turn the key to unlock a huge stainless steel door. I anxiously punch in the code on the control pad with one hand; the other hand hovers near my gun. (Having grown up on a diet of Stephen King novels I wasn't taking any chances.)

I step off the stool and slowly heave open the security door to the world of the dead...

Rationality Vs Fear

Welcome to my worst nightmare. Everybody has a hidden fear of the unknown - trouble is... I know only too well what lies beyond that heavy steel vaulted door; that's the problem. So in comes Darwin's theory... The fight/flight syndrome. The rational part of the brain is bypassed and we move right on in to the "attack or run" mode.

I knew that I was not under attack, but the 'enemy' as such lay beyond that door. Therefore the flight urge became stronger than rationality. If what lay inside was not going to hurt me, then why in hell was the door so securely locked and alarmed?

I swear that had something groaned or moved I was going to shoot it out like Rambo.

The reports I would have had to submit would have tied me up for months, nicely typed triple copies stating... "I have to report that... I willingly shot a mortuary freezer full of deceased persons whom I suspected of attacking me." One wonders if the defence counsel would have pushed Darwin's theory or just gone for the full-blown double assessment and had me committed. 

So why this lead in on my second article "The Morgue and Autopsy" in the Police procedures series? I just wanted you to know how bloody scary it can be at the Mortuary!

Welcome to the Dead Zone.

The mystery behind The Autopsy is about to be unveiled. We are all familiar with the word and the practise of the autopsy in the investigation of cause of death.

But what is actually involved? Why is an autopsy performed? How is it performed? Who needs to be present? Does it smell? Is it impersonal? What happens to the body bits? 

What is an Autopsy? 

In street terms it is the special surgical operation performed on deceased persons to discover the cause of death. A clinical specialist trained in the pathological investigation of the body performs the autopsy. This specialist has undergone significant training to qualify. An autopsy can be conducted in any death. The Coroner (as advised by the Commonwealth Medical Officer in an unexplained/sudden death, in a health crisis or a suspicious death) normally requests it.

Where is an Autopsy performed? 

In big cities an autopsy will be conducted at the Forensic Medical centre. In smaller towns it will be performed at the local morgue. The morgue is typically a barren unpopular place not frequently visited unless by demand or interment. It is what you would imagine, a cold, barren, unattractive place. 

That has explained the outside. Inside is much the same: colourless, cold, strong carbolic-smelling and, er... dead quiet. (Sorry, but it is.) The room layout is much as you would expect in a surgical hospital environment. Long stainless steel tables - minus the padding - with drainage troughs running each side of the table. Strong harsh lighting hangs overhead. The lack of life saving equipment and the anaesthetist's equipment is glaringly obvious. The stryker saw, cold solid tools and a large whiteboard fill the void.

A smaller partitioned area with a glass window is set aside for the identification and viewing of the victim. 

Of course the main feature wall is different to most. It is usually a strikingly solid door that contains the vaulted safe. Inside it may contain smaller drawers that slide in and out. The deceased are stored in these. Sometimes if the drawers are full, the bodies may be stored on trolleys within the freezer. 

Admission Procedures:

When Police admit a body it is taken to the morgue by the funeral attendants or by the coroner's office. Police meet the attendants and unlock the premises. Then the body is received and recorded in the register. The register number, date and name are recorded on a soft metal toe tag which is tied to the big toe. (The fight or flight response can also kick in at this time). The body is then placed in the freezer. A body count is often done to verify the records. The attending Police will return for the scheduled autopsy date. The body will be identified by next of kin if it has not been identified and identity established if possible.

What happens to the body before the autopsy? 

The morgue attendant will collect the body from the freezer and the toe tag will be checked with the book register to identify that the correct body is to be examined.

The police involved in the case generally stand to the side while the preparations are done. They are required to witness the entire autopsy to verify the collection of the tissue samples, and procedure. 

I always found the waiting the hardest part. Once the first incisions were made I took a clinical interest in the rest of the procedure.

The morgue attendant will set up the required tools and specimen jars required for the autopsy. Details of the deceased will be recorded on the labels and white/chalkboard.

The Autopsy

The Pathologist will examine the body first fully clothed, then naked. Blood stains, powder, grass stains, residue, any fibrous material will be noted and recorded. The body and injuries will be photographed and recorded. A diagram of the body on a clipboard will often be used to record data. Other recordings can be done with a voice recorder.

If necessary the body will be x-rayed to determine the direction of a trajectory or to reveal fractures, direction of head injury blows or embedded objects that may be otherwise overlooked.

All physical details of the body will be noted and recorded such as height, weight, tattoos, scars, age, bruising and the general condition of the body. Signs of small puncture or needle marks will be closely looked for on the body. A full assessment will be made on the back of the body too. The external examination is as vital as the investigation of the interior of the body.

Once the body has been fully examined the Pathologist is ready for the next stage.

If in the case of a possible fatal wound, the bullet hole, or stab wound will be measured and photographed. Any implements used still piercing the body will be recorded, photographed and measured. Then they are removed, bagged, tagged and kept for evidence.

The ins and outs of the Autopsy

  • A body chock is used to project the shoulders back and chest forward. 
     
  • Incisions are made to open the body. The incision will be made from the shoulders to mid chest and the pubic region in a "Y" shape. There is almost no bleeding in this procedure due to the absence of blood pressure. 
     
  • A saw will cut the rib bones to allow access to the chest cavity. 
     
  • Skin is peeled back and examined. 
     
  • The chest organs, heart and lungs are examined in situ then removed. 
     
  • They are each examined, weighed and tissue samples taken for pathology. Each organ will be measured and weighed on a set of scales for this purpose. All details are recorded. The heart will be thoroughly examined with each of the blood carrying arteries separated to look for blockages. Segments of each organ will be kept and preserved in a marked solution.
     
  • The abdomen is dissected to free the large intestine. The kidneys, liver, spleen and gastric contents will be examined. Each organ will be weighed, checked for abnormalities in size or condition and samples taken. 
     
  • The contents of the stomach will be examined. This can indicate when the person last ate, what was eaten and help establish a time of death if unknown. Samples will be taken to check for poisoning and for toxicology testing. This stage of the autopsy is not pleasant-smelling as you would imagine. Human muscles smell, but the gastric contents are putrid. Unavoidably there isn't much you can do but cover your nose.
     
  • Proceeding to the lower areas of the body: genitalia will be examined. 
     
  • In women the uterus, ovaries and vagina are carefully examined for signs of rape, pregnancy, or assault. These organs will be removed, weighed and samples taken.
     
  • The final area to be examined is the head. This is often the most disturbing part.
     
  • The neck will be extended forward by a head chock. The incisions made here are done across the hairline from ear to ear. The skin flaps are then pulled forward across the face and backwards to reveal the skull. The skull will be examined for fractures that may have resulted from injury. Two saw cuts are then made with a Stryker saw. This saw is designed specially to cut through bone and not soft tissue. This is definitely the worst part of the procedure. It is an awful mixture of smells from steel and bone and a horrific noise that leaves your blood running cold.
     
  • The saw cuts are made at the front and one in the back of the skull. This section is then removed allowing the brain to be seen. The brain is removed and examined for colour, damage, size and weight. Tissue samples are taken. Again all details are recorded.
     
  • The final procedure is to return all the organs to the internal abdomen cavity. This is literally a hodgepodge of organs in the body cavity. The brain is not replaced in the skull. The body is then sewn up and the face flaps returned to normal. The removed section of skull is replaced and then all carefully sewn, keeping in mind that the body may need be available for viewing before burial. 
     
  • The Pathologist's findings, reports and photographs are turned over to the Coronial Enquiry or become a case file for evidence in a court of law.
     
  • The body is then turned over to the family for disposal.

To conclude I must add that during the many autopsies I was required to attend I found the procedure to be highly professional, clinical and the deceased were always treated respectfully. 

NB - I never did draw my gun, I haven't been committed and am still at large. The nearest fight or flight responses I have these days are all associated with the hockey field.

(c) copyright Tracey Hawkins

 

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